NICE: A fundamental change

The institute aims to drive up standards

The National Institute for Clinical Excellence (NICE) is perhaps the most fundamental of the government's changes.

It has been set up to end so-called "prescribing by postcode".

Its central aim is to ensure equality of access to NHS treatments, regardless of where a patient lives.

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It is the first time a central body will exist to provide health professionals with expert advice and guidance on the use of new drugs and treatments.

In the past, individual health authorities have largely been left to decide whether to adopt new treatments, with the result that provision has been variable and piecemeal around the country.

The government hopes that the creation of NICE will usher in a uniform approach to the use of new treatments that will end the confusion, uncertainty and inequalities of the past.

NICE will be made up of medical experts, NHS managers and patient representatives, and will be chaired by Sir Michael Rawlins, professor of clinical pharmacology at Newcastle University.

It is charged with drawing up clear, consistent guidance for health professionals about which treatments work best for which patients.

NICE will lay down 10-15 guidelines a year on best treatments and appraise some 30-50 drugs and medicines for cost effectiveness and clinical efficiency.

Wherever appropriate, NICE guidance will cover all aspects of the management of a condition - from self care through to primary care, secondary care and more specialist services.

The findings will be disseminated to frontline NHS staff and will be available to patients.

It is also hoped that NICE will speed up the pace at which good value treatments are introduced across the NHS.

For example, even 15 years after the initial discovery of the benefit of eradicating H. pylori in the treatment of ulcers, many patients are still not receiving optimal drug treatment.

Professor Rawlins said: "Patients can expect a much more even treatment pattern across the country, much better treatment in some instances and they can also expect to see an end ot postcode prescribing."